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Should Diabetics Eat Fruit?
This is a tricky
question. On the one hand, most of the calories in fruit come from
carbohydrates which of course is something diabetics have to watch very
closely or their blood sugar may spike. Additionally, most fruits have a
high glycemic index compared to low carb high protein foods. On the
other hand, some fruits are extremely high in antioxidants, vitamins,
minerals, and fiber if eaten in their unadulterated raw form. There is
no question that fiber helps regulate blood sugar. Scientific studies
are rapidly proving the powerful health benefits of antioxidants. These
include antioxidants that help regulate insulin and help our cells
become more sensitive to insulin, i.e. they help reverse diabetes. They
also include antioxidants that help fight off health complications that
diabetics are more susceptible to including heart disease, premature
aging, stroke, and cancer. The pectin found in apples has been shown to
improve glucose metabolism. Early studies show grapefruit can also lower
blood sugar.
My take on this is that most diabetics should eat
fruit BUT they should be very prudent about how they go about it. The
primary purpose of this article is to give those with diabetes (and
those who love them) practical information they can use to make wise
decisions about which fruits they eat and how to eat them.
One
important caveat: From a strict botanical perspective, some foods which
we call "vegetables" are technically fruits but I am not including a
discussion of these in this article. I do want to mention that many of
these "vegetable fruits" are superstars in the diabetic diet. For
example, a medium-sized peeled cucumber which is technically a fruit has
only 3 net carbs and an extremely low glycemic load of 1 plus they are
chock full of nutrients and fiber.
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What Are the Best Fruits For Diabetics?
The
best fruits for diabetics, taking all important factors into
consideration, are berries. Relative to other fruits, berries are low
carb and have a low glycemic index (20 - 45 GI, usually on the lower end
of this). They are also exceptionally high in fiber and antioxidants.
Within the most common berries consumed in the US, raspberries and
blackberries have less carb and a lower glycemic index than blueberries
but you can adjust your serving size to compensate for this. For
example, a 100 gram serving (about 2/3 cup) of raspberries or
blackberries has approximately 6 net carbs whereas the same volume of
blueberries has 12 net carbs. So, if you're keeping your carbs super low
you may want to reduce your serving size of blueberries to 1/3 - 1/2
cup.
Diabetics Should Favor Fruits That Are Relatively Low
Carb, Have a Relatively Low Glycemic Number, and Are Relatively High In
Fiber
Besides berries which I've identified as the #1 choice
overall, a small serving of apples (12-26 g/fruit), citrus (8-22
g/fruit), and stone fruits (1-19 g/fruit) a few times a week can be part
of a healthy diet for most diabetics. These fruits have a relatively
low glycemic index and relatively low carb per fruit. Stone fruits are
fruits that have a single large pit (the "stone") in the middle with a
sweet fleshy outer layer around it. These include cherries (1 g/fruit),
peaches (11-19 g/fruit), plums (7 g/fruit), apricots (3 g/fruit), and
nectarines (12-13 g/fruit). For your easy reference, I've included the
estimated range of net carbs in grams per fruit. If you're on a really
low carb diet (less than 30 carbs per day usually) or you are gaining
unwanted weight, you may have to really curtail fruits. It is
interesting to note that stone fruits are all members of the genus
Prunus which also includes almonds, a superstar in the diabetic diet,
and that a peach pit looks a lot like an almond shell. The edible skins
of fruits tend to be very high in fiber so be sure to eat your apple
peels and that fuzzy peach skin!
Cantaloupe (aka ground melon),
watermelon, and pineapple are examples of fruits that are very high in
carb so you might want to eat them only occasionally.
Bananas Are Very Popular In the American Diet But...
Bananas
are the most popular fruit in America, even surpassing apples and
oranges. However, bananas have 17-31+ grams of carb and have an average
glycemic index of 55 which can be much higher with a really ripe super
sweet banana (the way I like 'em). If you really miss banana, I
recommend eating them only 1-2 times a week and eating only half a
banana as a single serving. Plus, you can pick out small bananas when
you shop to lower the carb.
Diabetics Should Avoid Fruit Juice and Dried Fruit
Even
if you drink the unsweetened kind, fruit juice contains little to no
fiber and is very high in sugar with a high glycemic index. Because of
this, even a small amount of juice can play haywire with your blood
sugar levels. Plus, when you drink juice, you miss out on many nutrients
you'd have in the actual whole fruit. Dried fruit highly concentrates
the sugar and should therefore definitely be avoided by diabetics.
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Eat Fruit With Other Foods
This
is a very important point so pay close attention. When diabetics eat
foods that are higher in carbs and have a higher glycemic index such as
fruits, they should always try to eat some protein and healthy fat along
with it. The protein and fat balances out the effect of the
carbohydrates in the fruit and you will get less of a spike in your
blood sugar. A really good combination seems to be eating fruit with
nuts. You can also combine eating fruit with some low carb yogurt,
cottage cheese, hard cheese, or eat your fruit as part of a full meal. I
love eating a small bit of fruit as a dessert. Use common sense though.
If your meal already has a significant number of other carbs (like
grains), you may want to skip the fruit.
Try To Eat Fruit Earlier In the Day
It
seems that for most diabetics fruit has less effect on their blood
sugar levels if they eat it earlier in the day. So, try to eat your
fruit as part of your breakfast or lunch. This is especially true if you
are experiencing the "dawn phenomenon" where your early morning blood
sugar readings are much higher than they were when you went to bed. In
this case, you should definitely avoid eating fruit at night and see if
that makes a difference.
Pay Attention To Your Whole Diet and Keep It In Balanced
Let's
say you go on a beautiful summer picnic and you splurge on some very
sweet watermelon (yum!). To compensate, you may want to watch your carbs
more carefully for the rest of the day and maybe eat a lower carb
dinner. If you just have to have a banana with your breakfast (I suggest
eating half of a small banana), try to eat a lower carb lunch and limit
your other carbs at breakfast.
Pay Very Careful Attention To Serving Size
The
phrase "eat in moderation" takes on new meaning for the diabetic. Food
is medicine for the diabetic and can even reverse diabetes if you know
what to eat and stick to it but it can also exacerbate the disease if
you eat the wrong foods. When it comes to eating carbohydrates, no
matter how healthy food item is, serving size is the most important
factor. Yes, fruits are healthy in many ways but if you are diabetic, it
is crucial you do not over-indulge in fruit. Doing so bcould result in a
huge spike in your blood sugar, and worse, if you over-indulge too
often you could make your cells less receptive to insulin.
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I know
the natural tendency of most Americans is to pick out larger sized
fruit, which is why cultivators select for it. However, a simple trick
for diabetics who want to limit their carbs is to pick out smaller
fruit. It is generally just as tasty as the bigger fruit. Let me give
you a few examples to illustrate the carbs you can save by doing so. A
six inch banana has 17 net carbs whereas a nine inch banana has 31 net
carbs. That's a 14 carb difference! That's very significant. Even if you
eat just half a banana, that's still a 7 carb difference. Try to pick
out small bananas. A small tangerine is only 9 net carbs (clementines
are only 8 net carbs) whereas a large tangerine is 14 net carbs. You may
even want to pick tangerines over oranges because even a small orange
is 16 net carbs which is more than the largest tangerine. If you really
want to limit your carbs, you may want to pick apricots and plums (3 and
7 net carbs respectively) over peaches and nectarines (11-19 net
carbs). It's hard to resist eating the entire peach and it's awfully
messy to slice and leave half (but possible). With cherries, you can
simply count out the number of cherries by the number of carbs you can
afford since they are 1 net carb per cherry. How convenient of them
(smile).
Be Careful, You May Be Eating More Carbs Than You Think
I
think many diabetics and low carb dieters grossly underestimate the net
carbs in the fruit they eat. There are many reasons for this.
It
is easy to be fooled when you look up the nutritional values of fruit.
The value you get is probably an average value. The average may not be
as big or as ripe as the fruit you are actually eating. The tests may
have been conducted with a different species or variety that is more or
less sweet or has more or less fiber than the fruit you are actually
eating. There is a lot of variation between varieties in fruit and it
can make a HUGE difference in the actual nutritional values. Even if you
are comparing the exact same variety/species, your fruit may have been
grown in a different soil type. Bottom line, you need to take the
nutrition values you find for fruit with a grain of salt and be very
aware that the values can vary greatly - much more so than with other
types of foods like meat and dairy.
Cultivators and food science
geeks play with genetics of fruits in an effort to make us, the
sugarophilic super size that please consumers that we are, happy. I've
read that the sugar content in cantaloupe doubled between 1950 and 1999.
The values for fruit in the USDA Food Database were recently updated
because they were so underestimated because fruits have gotten so much
bigger and sweeter.
When you pick out fruit, don't you tend to
pick out the ripest, sweetest, most tantalizing fruit you can find? I
know I do. In general, as a fruit ripens its carb quantity goes up,
especially if it ripens before it is picked. Have you ever heard anyone
say, "That fruit was as sweet as candy?"
Know Your Own Body
There
seems to be more variability in how diabetics respond to fruit than
just about any other food type. For some diabetics, eating a whole apple
seems to be just fine while with others eating just half an apple can
send their blood sugar soaring through the roof. For this reason, you
need to do some very careful testing to see how your body responds to
fruit so you will know what quantities and which fruits you can eat
without causing ill effects.
ou'll want to keep the testing as simple
as possible. Measure out a certain quantity of fruit, perhaps a half cup
or whole cup of a fruit you'd like to eat, and test your blood sugar
just before you eat it and then again 1.5 hours after you eat it.
Compare these readings to what happens when you eat a low carb high
protein snack at the same time of day under as many of the same
conditions as possible. You can try increasing or decreasing the amount
the next day depending on the initial result and you can try other
favorite fruits.
Keep in mind that many other factors such as other
foods you eat around the same time, how much exercise you've recently
gotten, how much sleep you had the night before, how stressed you are,
what you do in that 1.5 hours between tests, etc, etc can all affect the
results so you'll want to test more than once to see how consistent
your results are. If your blood sugar does spike after eating a
reasonable portion of fruit, I encourage you to re-test in a month or
two if you adhere to a good and consistent low carb diabetic diet and
make other healthy lifestyle changes during that time such as getting
more exercise, sleeping more, and lowering stress.
Once the body has had
time to heal itself, i.e. once you've had time to reverse your
diabetes, you will likely be less insulin resistant (this is what
happened to me) and your body may be able to handle reasonable portions
of fruit (and a few other carbs) without the spikes in blood sugar.